Individual provider Active NPI

Amanda Isabel Guardia, DPT, PT

  • Physical Therapist
  • Davie, FL
National Provider Identifier
1093421539
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39750 Issued in FL
Practice address
10650 W State Road 84 Ste 111
Davie, FL 33324-4235
Phone
(956) 878-8357
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39750 FL Primary

Addresses

Primary practice location

10650 W State Road 84 Ste 111
Davie, FL 33324-4235

Mailing address

8900 NW 97TH Ave Apt 208
Doral, FL 33178-2766
Phone (956) 878-8357

Other practice location 1

454 N University Dr
Pembroke Pines, FL 33024-6720
Phone (954) 443-1926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726000211 FL Practitioner - Physical Therapist in Private Practice 7911368881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39750FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Rehabilitation Center CurrentSince Jun 1, 2023 Accepting new patients
Atlantic Rehabilitation Center CurrentSince Jun 1, 2023 Accepting new patients

Locations

16249 Biscayne Blvd
Aventura, FL 33160
Phone (305) 405-0400

11870 Sr 84
Bldg C3
Davie, FL 33325
Phone (954) 474-3611

17900 NW 5th St
Ste 102
Pembroke Pines, FL 33029
Phone (954) 251-0733

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1093421539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 NW 97TH AVE APT 208",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782766",
            "telephone_number": "956-878-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 W STATE ROAD 84 STE 111",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244235",
            "telephone_number": "956-878-8357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "454 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330246720",
            "country_code": "US",
            "telephone_number": "954-443-1926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUARDIA",
        "first_name": "AMANDA",
        "middle_name": "ISABEL",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "39750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.